HomeMy WebLinkAboutDrain Layers Permit 56 Lisa Drive (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3590 Con..t<r9: r COX C'OMM...UNICATIONS
Location 0056 LISA DRIVE Addre�:� 807 PPgRKER`'S.T.
Type Work CABLE
NCHE"STU,CT` ;..
Q`6.04: 'C 06Q.40
Ihone'Ito 8:60)432'52]1
Date Insp Needed ----------------
Aate Insp 'j
Time Insp Needed ------------- Time Iipg`
Inspected By
Work in Progress — --_{
---
- -=
I
i
Input _ Date --- �— —v
3
Permit No. 3590 Town of South Windsor, CT
Date 09/12/2003 Street Excavation Permit
Expiration Date 09/11/2004
Descrip:
Applicant
Location
Name COX COMMUNICATIONS 065;6. LISA pk1IVE
Addr. 801 PARKER ST...
{
06040 CT 06040 'Ype of 'Wark CABLE.
Phone (860)432-5211'
Applicant agrees to ftirxtish the-Town of:;Bput,h Windsor the: amount of bond
required and to reimburse the Town xis youth 8
t3ndor for any expenses
incurred by the Town fors:ma nt:enance or repair wg k x�i" connect'ion with this
permit and that applicant is f'am]. iaT w Ft... szi will .abide by ::the rules and
regulations for permitsa ouained in te;.Tcwti...of South Wi'ndsor's Street
Cut Permit Manual.
* * PERM T TO BE XEPT 94'JOB SITE AT,.ALL TIMES.
Issued by _ Title
------ --
Date Completed
_________________ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
SD : TOWN OF SOUTH WINDSOR
-� PUBLIC WORKS DEPARTMENT
TOWN HALL
D 1 1540 SULLIVAN AVENUE
�� SOUTH WINDSOR, CT
FEE -®r-2-16
Name of Firm sv�-{IA. 1 t C dX�Address of Phone No. (c — �Q
Firm M L Z
Location of proposed work
Describe fully nature of permit requested ` —
Starting datYe C Approx. time for compietion;
Call Before ou Rig No Traffic Services Control No.
Show sketch of proposed work or furnish To-be.fiped out by Town of South Windsor
two copies of separate drawing
Indicate North Payerneryt Cut
Prop.size of cut
No.cuts
Amt. of Deposit$
�jv�•�• oe
{— ()Cash O Check #
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town $
Applicant is responsible for contacting by the Police De t. and C.B.Y.D. date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN TFfE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title:
D.L.#:
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
— Stanch Excavation ermit' oc
S•d 088Zt7t,9098I 01 SS60T282Ti7 ISIf)-ia Aiitin H31 IM:W0d3 0b:80 2008-8S-d3S
o,' Mass: 888-344-7233
e.comPswrd DIG SAFE 20033703 �� CLEARS
023WS .�/
023wE Mass i0# ';
17930 NUMBER ON
17
Conn:800-922-4455
CBYD.Corn Pswrd �/
WITCHEQUIP
Contractor#9187
DATE
103 STREET' "
ADDRESS r/27- All 04
47
,�,�:= ;�• :: � a, �' i � s w GROSS ST
�.+'rrwi-i�95r'� uru h-
� It CHANGElRD"EFMNr 24" CATV WORK MARKED ? YES
T F t A i
rKfx T 7 Ls. sr.•+ c r.. ':.
04
_
� mil. �i,•^'."X F--i ii•` Jr
.�..��ixilnM1'••�if��:•. •.ifi,�'
r #'�'c••:.e.•' 9. a-+ y, � es ; �q x7r x"'v +++. ;
ice■..i.A,a���-�.�y�� � �axt,iwx-f. � :�'
>�..#• f-;3^='., s a.a E..35��"',34rnr k'3{� x.:Z`Afp;cam. i�.��ra� .
d'd 08a"9098T:01 SS60T882Tb ISIf1I0 Aii-iiin H31IM:W0dJ [fib-80 2002-2T-d3S